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Loyola wraps up longest kidney chain in U.S.

Loyola wraps up longest kidney chain in U.S.

Dr. John Milner, a kidney and liver surgeon at Loyola University Medical Center, explains how kidney transplant chains are transforming the field of transplant medicine. Kidney disease patients who otherwise might languish for 5 to 10 years waiting for a kidney now can find a match within just a few months. Without kidney transplant chains, these patients would have no other choice than to undergo years of grueling and time-comsuming dialysis therapy.

Two Loyola patients recently took part in a 30-patient kidney transplant chain, the longest in medical history. The generosity of altruistic donors and our close working relationship with the National Kidney Registry made this happen.

Living-donor chains have the potential to dramatically reduce transplant waiting times for thousands of patients. Loyola has started 13 kidney transplant chains. That's second only to Cornell, which has started 17 chains, according to the National Kidney Registry, which coordinates kidney chains. In 2011, Loyola started more chains than any other center.

Dr. John Milner, a Loyola transplant surgeon, is a national leader in kidney transplant chains and a member of the Medical Board of the National Kidney Registry. Joe Sinacore, the registry's director of research and education, said Milner is one of the nation's most passionate and effective advocates of kidney chains.

Patients typically must wait as long as 5 to 10 years to receive a kidney from a deceased donor. Having a living donor can eliminate the wait. But in one-third of such cases, a transplant can't be done because the immune systems of the patient and a willing donor don't match.

A kidney chain provides an innovative solution. Each chain begins when a good Samaritan steps forward to donate a kidney, expecting nothing in return. For example, say the good Samaritan donates a kidney to a patient we'll call John. John's wife, Mary, would have donated a kidney to her husband, but her kidney doesn't match. So instead of donating to John, Mary "pays it forward" by donating to a second patient, Bill. Bill's sister is willing to donate, but she doesn't match Bill. So she instead gives her kidney to a third patient, who she does match.

The chain can go on indefinitely, moving from hospital to hospital across the country. It stops only when a recipient does not have a friend or family member who can keep the chain going. The previous record for the longest chain, set in 2010 by the National Kidney Registry, was 23 transplants.

The recent record-breaking chain began when a good Samaritan donated a kidney at Riverside Community Hospital in Riverside, Calif. His kidney was flown cross-country to a recipient at St. Barnabas Medical Center in Livingston, N.J. From there, the chain moved back and forth across the country, stopping at Loyola on the 12th link, and finishing at Loyola on the 30th link.

The last donor in the chain was a 59-year-old California woman. Her kidney was removed at UCLA and flown in the middle of the night to Loyola. Milner and transplant surgeon Amy Lu performed the historic final transplant in the chain.

The chain ended with the Loyola patient, Don Terry, because he did not have an available donor to keep the chain going. His only sibling, a brother, is deceased, and his elderly parents are unable to donate for medical reasons.

The National Kidney Registry ended the chain at Loyola, rather than at another center, because Loyola had started so many previous chains with good Samaritan donors. This made Loyola eligible based on the registry’s chain-ending policy.

Thirteen chains have started at Loyola. So far, 11 chains have ended at Loyola, benefiting 11 patients who otherwise would have languished on the waiting list. "Loyola has been a beneficiary of its own altruism," Sinacore said.

Six other Loyola patients have also been involved in transplant chains, bringing the total to 17.

Of the 13 good Samaritans who jump-started kidney transplant chains at Loyola, five are Loyola employees who donated kidneys to strangers. Two other Loyola employees have given kidneys to acquaintances. Collectively, they are known as the Seven Sisters of Loyola. Loyola is believed to be the only organization in the world in which seven employees have donated kidneys to non-relatives.

The National Kidney Registry has coordinated 77 transplant chains that have provided kidneys to 393 patients. That's just a start. Milner said kidney chains have the potential to provide kidneys to as many as 20,000 patients immediately, and 3,000 patients per year thereafter.

"This is the best way for patients with incompatible donors to be transplanted quickly with the best results," Milner said.

For more information, please call (708) 327-4897 or (800) 424-6120. To speak to a living-donor coordinator at Loyola, call (708) 327-2696.

Paulette Behan of West Chicago, Ill., and her younger sister, Sunni Stupka of Baldwyn, Miss., are very close.

They text every day and talk at least once a week. So when Sunni learned that Paulette needed a kidney transplant, she was eager to donate one of hers.

But Sunni's kidney didn't match Paulette's immune system. If Sunni donated to Paulette, her kidney would be rejected.

"It broke my heart," Sunni said. "I felt like a failure, like I had let her down."

Then the sisters learned about an innovative kidney transplant chain available at Loyola University Medical Center. Transplant surgeon Dr. John Milner explained that Paulette could receive a kidney from a donor in Pittsburgh who matched her. In return, Sunni would promise to donate a kidney to a matching patient in California. Paulette became the 12th link in what would become the world's longest kidney transplant chain.

The kidney from the Pittsburgh donor was flown to Loyola from Allegheny General Hospital in Pittsburgh. Four days after Milner transplanted the kidney into Paulette, Loyola's Chair of Surgery, Dr. Paul Kuo, removed a kidney from Sunni. Sunni's donated kidney then was flown to a waiting patient at Loma Linda University Medical Center.

Don's Story - Final Link in Record-breaking Kidney Transplant Chain

Don Terry of Joliet, Ill., is the 30th and last recipient in the world's longest kidney-transplant chain.

Terry, 46, has Type 2 diabetes. His kidneys began to fail two years ago, and he went on dialysis in January 2011. He was put on a transplant waiting list and told it could take as long as 5 to 10 years.

Terry has a full-time job with the U.S. Social Security Administration. Being on dialysis, he said, was like having a second, part-time job.

A diabetes patient on dialysis typically does not have a long life expectancy. Terry worried that he might not live to see his 50th birthday. "What bothered me the most was the possibility of leaving family members like my mom and dad by themselves, and having them see their son pass away from an excruciating disease," he said.

Then Terry read about Loyola University Medical Center's participation in kidney transplant chains, which are designed to eliminate waiting times for kidneys. Terry made an appointment with Dr. John Milner, one of the nation's leading transplant-chain surgeons.

A kidney became available from a donor in California who matched Terry. The surgery was successful, and Terry recently returned to work.

"I think I have more energy now than I had when I was in my 20s," he said." I have made it my life's mission to make people aware of kidney chains."